• 제목/요약/키워드: Option Selection

검색결과 136건 처리시간 0.022초

A Study on the Clinical Study of Herbal Medicine for Postmenopausal Osteoporosis (폐경기 골다공증에 대한 한약 임상 연구 고찰)

  • Young-Eun Kim;Hee-Yoon Lee;Jang-Kyung Park;Young-Jin Yoon
    • The Journal of Korean Obstetrics and Gynecology
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    • 제36권3호
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    • pp.129-153
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    • 2023
  • Objectives: The purpose of this study is to report the clinical effectiveness and safety of herbal medicine treatment for postmenopausal osteoporosis. Methods: Researchers searched papers through 5 online databases including The Cochrane Library Central, Pubmed, China Academic Journal (CAJ), Oriental medicine Advanced Searching Integrated System (OASIS) and Korean studies Information Service System (KISS). Randomized controlled trials (RCTs) that used herbal medicine as treatment were included. Results: Twenty three studies were selected by the selection and exclusion criteria. The treatment group was treated with herbal medicine alone or with herbal medicine and conventional medicine. The control group was treated with conventional medicine. Most common evaluation index was Bone Mineral Density (BMD) followed by total efficacy rate and level of bone metabolism markers, level of sex hormones, etc. Compared with the control group, the treatment group was more effective and safer in all of 23 studies. Conclusions: Herbal treatment alone could be an effective and safe option in treating postmenopausal osteoporosis. Moreover herbal treatment with conventional medicine could improve its therapeutic effect on postmenopausal osteoporosis as well.

Free tissue transfer for reconstruction of axillary defects: two case reports

  • Asha Deepthi Bathini;Parvathi Ravula;Srinivas Jammula;Srikanth Rangachari;Priyanka Pereira
    • Journal of Trauma and Injury
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    • 제36권4호
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    • pp.425-430
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    • 2023
  • Axillary defects need pliable, vascular tissue to cover the critical structures traversing the axilla and to allow near-normal range of motion in the shoulder. Although local flaps are the first choice, free tissue transfer is a good option when local tissues are injured or scarred. Herein, we report two cases of axillary defects that were reconstructed using anterolateral thigh free flaps. One was a post-electric burn axillary defect for which a thoracoacromial pedicle was used as the recipient, and the other was a posttraumatic axillary defect with the transverse cervical vessels as the recipient. In both patients, the flap survived well with no complications and resulted in adequate functional recovery. In large defects of the axilla with a scarcity of local tissues, free flaps can yield optimal results. The proper selection of recipient vessels and a donor flap with adequate pedicle length impact the outcomes of such reconstruction.

Management of Severe Bone Defects in Femoral Revision following Total Hip Arthroplasty

  • Yicheng Li;Li Cao
    • Hip & pelvis
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    • 제36권2호
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    • pp.101-107
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    • 2024
  • Treatment of femoral bone defects continues to be a challenge in revision total hip arthroplasty (THA); therefore, meticulous preoperative evaluation of patients and surgical planning are required. This review provides a concise synopsis of the etiology, classification, treatment strategy, and prosthesis selection in relation to femoral bone loss in revision THA. A search of literature was conducted for identification of research articles related to classification of bone loss, management of femoral revision, and comparison of different types of stems. Findings of a thorough review of the included articles were as follows: (1) the Paprosky classification system is used most often when defining femoral bone loss, (2) a primary-length fully coated monoblock femoral component is recommended for treatment of types I or II bone defects, (3) use of an extensively porous-coated stem and a modular fluted tapered stem is recommended for management of types III or IV bone defects, and (4) use of an impaction grafting technique is another option for improvement of bone stock, and allograft prosthesis composite and proximal femoral replacement can be applied by experienced surgeons, in selected cases, as a final salvage solution. Stems with a tapered design are gradually replacing components with a cylindrical design as the first choice for femoral revision; however, further confirmation regarding the advantages and disadvantages of modular and nonmodular stems will be required through conduct of higher-level comparative studies.

Endoscopic treatment for rectal neuroendocrine tumor: which method is better?

  • Seung Min Hong;Dong Hoon Baek
    • Clinical Endoscopy
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    • 제55권4호
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    • pp.496-506
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    • 2022
  • Recently, research on rectal neuroendocrine tumors (NETs) has increased during the last few decades. Rectal NETs measuring <10 mm without atypical features and confined to the submucosal layer have only 1% risk of metastasis, and the long-term survival probability of patients without metastasis at the time of diagnosis is approximately 100%. Therefore, the current guidelines suggest endoscopic resection of rectal NETs of <10 mm is regarded as a safe therapeutic option. However, there are currently no clear recommendations for technique selection for endoscopic resection. The choice of treatment modality for rectal NETs should be based on the lesion size, endoscopic characteristics, grade of differentiation, depth of vertical involvement, lymphovascular invasion, and risk of metastasis. Moreover, the complete resection rate, complications, and experience at the center should be considered. Modified endoscopic mucosal resection is the most suitable resection method for rectal NETs of <10 mm, because it is an effective and safe technique that is relatively simple and less time-consuming compared with endoscopic submucosal dissection. Endoscopic submucosal dissection should be considered when the tumor size is >10 mm, suctioning is not possible due to fibrosis in the lesion, or when the snaring for modified endoscopic mucosal resection does not work well.

Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review

  • Massimiliano Polastri;Esra Pehlivan;Robert M. Reed;Allaina Eden
    • Journal of Yeungnam Medical Science
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    • 제41권4호
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    • pp.235-251
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    • 2024
  • Lung transplantation is an elective treatment option for end-stage respiratory diseases in which all medical therapy options have been exhausted. The current study aimed to identify updated information on the postoperative conditions that may impair rehabilitation after lung transplantation and to provide specific considerations of their clinical relevance during the recovery process. The present study is a systematic review conducted by searching three primary databases: the United States National Library of Medicine PubMed system, Scopus, and the Cochrane Library. The databases were searched for articles published from database inception until May 2024; at the end of the selection process, 27 documents were included in the final analysis. The retrieved material identified 19 conditions of rehabilitative interest that potentially affect the postoperative course: graft dysfunction, dysphagia, postsurgical pain, cognitive impairment, chronic lung allograft dysfunction-bronchiolitis obliterans syndrome, phrenic nerve injury, delayed extracorporeal membrane oxygenation weaning, airway clearance, refractory hypoxemia, mediastinitis, reduced oxidative capacity, sternal dehiscence, coronavirus disease 2019 (COVID-19), gastroparesis, ossification of the elbow, Takotsubo cardiomyopathy, airway dehiscence, recurrent pleural effusion, and scapular prolapse. Although some patients are not amenable to rehabilitation techniques, others can significantly improve with rehabilitation.

Reconstruction of Ischial Soft Tissue Defects using Adductor Magnus Perforator Island Flap (대내전근 천공지 도상 피판을 이용한 좌골부 연부조직결손의 재건)

  • Kim, Eui Sik;Park, Jang Wan;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • 제36권5호
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    • pp.559-564
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    • 2009
  • Purpose: Surgical reconstruction of an ischial soft tissue defect presents a challenging problem owing to a high rate of recurrence, especially paraplegic patients. Although various muscle, musculocutaneous and fasciocuta - neous flaps have been used in the reconstruction of ischial soft tissue defect, it is still debated which type of flaps are the best. We had performed a relatively durable adductor magnus perforator island flap based on the perforators originated from the first medial branch of the profunda femoris artery for coverage of ischial soft tissue defect where was not a region universally reconstructed by perforator flap. Methods: From August 2005 until January 2008, the adductor magnus perforator island flap had been used for resurfacing of the ischial soft tissue defects in a series of 6 patients (4 male and 2 female). Ages ranged from 26 to 67 years (mean, 47.5 years), and follow - up period from 13 to 26 months (mean, 16.7 months). Causes were 4 pressure ulcers, 1 cellulitis and 1 suppurative keratinous cyst. Results: The sizes of these flaps ranged from 12 to 18 cm in length and 7 to 9 cm in width. The flaps survived in all patients. Marginal loss over the distal area of the flap by infection was noted in one patient, which was treated successfully with a subsequent split - thickness skin graft. Average thickness of the flap was 0.94 cm, which was more thicker than other perforator flaps. Long term follow - up showed a good flap durability. Conclusion: In planning a reconstructive option of ischial soft tissue defect, the adductor magnus perforator island flap is a relatively large cutaneous flap with a durable thickness. With proper patient selection, careful vascular dissection and postoperative management, we recommend this flap is a good and suitable option for coverage of the ischial soft tissue defect.

Status and Implications of Regulatory Frameworks for Environmental Management of Geologic CO2 Storage in USA and EU (이산화탄소 지중저장의 환경 관리를 위한 미국과 유럽연합의 법·제도 현황과 시사점)

  • Jang, Eunseon;Yun, Seong-Taek;Choi, Byoung-Young;Chung, David;Kang, Hun
    • Journal of Soil and Groundwater Environment
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    • 제17권6호
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    • pp.9-22
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    • 2012
  • Though geologic storage of $CO_2$ (GS) is considered as an attractive technological option to enormously reduce greenhouse gases emission into the atmosphere, many concerns on potential environmental and health risks associated with $CO_2$ leakage have been raised. In particular, groundwater contamination due to the brine displacement by a pressure build-up and the acidification by leaked $CO_2$ is paid a special attention. Therefore, integrated regulatory frameworks have been established by law in many countries to secure the permanent containment of injected $CO_2$. Regulatory frameworks deal with entire processes of GS, including site selection, monitoring and post-closure environmental management. This review paper provides a summary of regulatory frameworks in USA (U.S. EPA Geologic Sequestration Rule) and EU (Geologic $CO_2$ Sequestration Directive). The regulatory framework to properly address environmental issues should be established for the deployment of CCS projects in Korea.

Genetic Parameters for Milk Yield and Lactation Persistency Using Random Regression Models in Girolando Cattle

  • Canaza-Cayo, Ali William;Lopes, Paulo Savio;da Silva, Marcos Vinicius Gualberto Barbosa;de Almeida Torres, Robledo;Martins, Marta Fonseca;Arbex, Wagner Antonio;Cobuci, Jaime Araujo
    • Asian-Australasian Journal of Animal Sciences
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    • 제28권10호
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    • pp.1407-1418
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    • 2015
  • A total of 32,817 test-day milk yield (TDMY) records of the first lactation of 4,056 Girolando cows daughters of 276 sires, collected from 118 herds between 2000 and 2011 were utilized to estimate the genetic parameters for TDMY via random regression models (RRM) using Legendre's polynomial functions whose orders varied from 3 to 5. In addition, nine measures of persistency in milk yield ($PS_i$) and the genetic trend of 305-day milk yield (305MY) were evaluated. The fit quality criteria used indicated RRM employing the Legendre's polynomial of orders 3 and 5 for fitting the genetic additive and permanent environment effects, respectively, as the best model. The heritability and genetic correlation for TDMY throughout the lactation, obtained with the best model, varied from 0.18 to 0.23 and from -0.03 to 1.00, respectively. The heritability and genetic correlation for persistency and 305MY varied from 0.10 to 0.33 and from -0.98 to 1.00, respectively. The use of $PS_7$ would be the most suitable option for the evaluation of Girolando cattle. The estimated breeding values for 305MY of sires and cows showed significant and positive genetic trends. Thus, the use of selection indices would be indicated in the genetic evaluation of Girolando cattle for both traits.

Radiolabeling of nanoparticle for enhanced molecular imaging

  • Kim, Ho Young;Lee, Yun-Sang;Jeong, Jae Min
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • 제3권2호
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    • pp.103-112
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    • 2017
  • The combination of nanoparticle with radioisotope could give the in vivo information with high sensitivity and specificity. However, radioisotope labeling of nanoparticle is very difficult and radioisotopes have different physicochemical properties, so the radioisotope selection of nanoparticle should be carefully considered. $^{18}F$ was first option to be considered for labeling of nanoparticle. For the labeling of $^{18}F$ with nanoparticle, Prosthetic group is widely used. Iodine, another radioactive halogen, is often used. Since radioiodine isotopes are various, they can be used for different imaging technique or therapy in the same labeling procedures. $^{99m}Tc$ can easily be obtained as pertechnatate ($^{99m}{TcO_4}^-$) by commercial generator. Ionic $^{68}Ga$ (III) in dilute HCl solution is also obtained by generator system, but $^{68}Ga$ can be substituted for $^{67}Ga$ because of the short half-life (67.8 min). $^{64}Cu$ emits not only positron but also ${\beta}-particle$. Therefore $^{64}Cu$ can be used for imaging and therapy at the same time. These radioactive metals can be labeled with nanoparticle using the bifunctional chelator. $^{89}Zr$ has longer half-life (78.4 h) and is used for the longer imaging time. Unlike different metals, $^{89}Zr$ should use the other chelate such as DFO, 3,4,3-(LI-1,2-HOPO) or DFOB.

Transient Adverse Neurologic Effects of Spinal Pain Blocks

  • Lee, Han-Il;Park, Yong-Sook;Cho, Tack-Geun;Park, Seung-Won;Kwon, Jeong-Taik;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • 제52권3호
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    • pp.228-233
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    • 2012
  • Objective : Chronic neck or back pain can be managed with various procedures. Although these procedures are usually well-tolerated, a variety of side effects have been reported. In this study we reviewed cases of unexpected temporary adverse events after blocks and suggest possible causes. Methods : We reviewed the records of patients treated with spinal pain blocks between December 2009 and January 2011. The types of blocks performed were medial branch blocks, interlaminar epidural blocks and transforaminal epidural blocks. During the first eight months of the study period (Group A), 2% mepivacaine HCL and triamcinolone was used, and during the last six months of the study period (Group B), mepivacaine was diluted to 1% with normal saline. Results : There were 704 procedures in 613 patients. Ten patients had 12 transient neurologic events. Nine patients were in Group A and one was in Group B. Transient complications occurred in four patients after cervical block and in eight patients after lumbar block. Side effects of lumbar spine blocks were associated with the concentration of mepivacaine (p<0.05). The likely causes were a high concentration of mepivacaine in five patients, inadvertent vascular injection in three patients, intrathecal leak of local anesthetics in one, and underlying conversion disorder in one. Conclusion : Spinal pain blocks are a good option for relieving pain, but clinicians should always keep in mind the potential for development of inevitable complications. Careful history-taking, appropriate selection of the anesthetics, and using real-time fluoroscopy could help reduce the occurrence of adverse events.